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减重手术后的急诊就诊情况。

Emergency Department visits after bariatric surgery.

机构信息

Liv Hospital, Ankara, Turkey.

Liv Hospital, Ankara, Turkey -

出版信息

Minerva Surg. 2021 Feb;76(1):50-56. doi: 10.23736/S2724-5691.20.08554-5.

Abstract

BACKGROUND

Although bariatric surgery (BS) has an excellent safety profile, postoperative complications have undoubtedly increased due to the rise in the amount of operations performed annually. In parallel, the number of visits to the Emergency Department (ED) after surgery is increasing. The aim of this study was to describe the frequency, and the risk factors associated with postoperative ED visits after BS.

METHODS

This study included patients who had undergone different types of BS procedures between June 2016 and December 2019. Patients' prior surgery types, ED visiting timings, main complaints, symptoms and the diagnoses they received, readmissions, and the interventions they had were noted and compared.

RESULTS

A total of 408 patients operated on using either the robotic or laparoscopic method due to morbid obesity, including 91 (22.3%) SG, 231 (56.6%) OAGB, 62 (15.2%) SADS-p, and 24 (5.8%) RS, were included into the study. During follow-up, fifty-three of the 408 patients applied to the Emergency Department 62 times with different complaints. ED admission rates in the OAGB group were significantly higher (P=0.04). While the most common complaint seen in the patients admitted to the ED after BS was localized abdominal pain with 25.8%, the most common diagnosis of the patients was cholelithiasis with a rate of 16.1%.

CONCLUSIONS

ED visits after BS usually continue intensively during the first year. Most of these applications can be prevented with regular outpatient follow-ups. Some of these require life-saving surgery in emergency conditions and do not allow the patient to be transferred to a bariatric center.

摘要

背景

尽管减重手术(BS)具有出色的安全性,但由于每年手术量的增加,术后并发症无疑有所增加。与此同时,手术后到急诊部(ED)就诊的人数也在增加。本研究旨在描述 BS 手术后 ED 就诊的频率,以及与术后 ED 就诊相关的危险因素。

方法

本研究纳入了 2016 年 6 月至 2019 年 12 月期间接受不同类型 BS 手术的患者。记录患者既往手术类型、ED 就诊时间、主要主诉、症状及诊断、再入院和干预措施,并进行比较。

结果

共有 408 例因病态肥胖接受机器人或腹腔镜手术的患者纳入研究,包括 91 例(22.3%)袖状胃切除术(SG)、231 例(56.6%)胃旁路术(OAGB)、62 例(15.2%)可调节胃束带术-胃空肠分流术(SADS-p)和 24 例(5.8%)Roux-en-Y 胃旁路术(RS)。在随访期间,408 例患者中有 53 例出现不同症状就诊于 ED 共 62 次。OAGB 组的 ED 入院率明显较高(P=0.04)。BS 后就诊于 ED 的患者最常见的主诉是局限性腹痛,占 25.8%,最常见的诊断是胆石症,占 16.1%。

结论

BS 后 ED 就诊通常在术后第一年持续增加。大多数情况下,通过定期门诊随访可以预防这些就诊。有些情况需要在紧急情况下进行救命手术,患者无法转诊到减重中心。

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